| NPI | 1629101340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS BAUTISTA Internist 805-524-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A43293) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA15385) |
| 207Q00000X Family Medicine (Licence: CA A97270) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-01-31 |